Site Search Navigation

Site Navigation

Site Mobile Navigation

Ask Well: Is Mild Cognitive Impairment Reversible?

By Karen Weintraub December 29, 2015 5:45 amDecember 29, 2015 5:45 am

Photo

Credit Stuart Bradford

Q

Is mild cognitive impairment reversible?

Reader Question • 1279 votes

A

Mild cognitive impairment, or M.C.I., is not a disease in itself. Rather, it is a clinical description based on performance on a test of memory and thinking skills. Depending on its cause, mild cognitive impairment is potentially reversible.

Poor performance on a cognitive test could be caused by certain medications, sleep apnea, depression or other problems, said Dr. Alvaro Pascual-Leone, a professor of neurology at Harvard Medical School and Beth Israel Deaconess Medical Center. In those cases, when the underlying disease is treated, cognitive abilities can bounce back.

But in about half of people with M.C.I. – doctors are not sure of the exact number — memory problems are the first sign of impending Alzheimer’s disease. If M.C.I. progresses to Alzheimer’s, there is no recovery. Alzheimer’s is marked by an inexorable decline that is always fatal, although the path from the first signs of cognitive impairment to death may take three to 15 years, said Dr. David Knopman, a professor of neurology at the Mayo Clinic in Rochester, Minn.

As many as 20 percent to 30 percent of those with M.C.I. who score below but near the cutoff for normal can cross back above in a subsequent cognitive test – perhaps because they are having a better day, he said.

But someone whose score is borderline is at higher risk of developing Alzheimer’s than someone who scores higher, said Dr. Knopman, also vice chair of the medical and scientific advisory council of the Alzheimer’s Association.

Doctors may be hesitant to label someone with early Alzheimer’s, which can be difficult to diagnose in the early stages, so they often call it mild cognitive impairment instead, said Dr. John C. Morris, a professor of neurology and the director of the Knight Alzheimer's Disease Research Center at Washington University School of Medicine in St. Louis.

“What we really want to understand is not these diagnostic labels, but what is going on in the brain that’s causing this change,” he said, “and ultimately, when can we develop truly effective therapies to address these changes?”

Not all the cognitive changes that come with age are a sign of disease. All people forget where they put their keys once in a while, Dr. Knopman said. “Memory is really imperfect.”

Anyone concerned about his or her memory or the memory of a loved one should see a cognitive specialist, bringing along a spouse, friend or adult child to provide perspective on any changes, he said.